MP52-11 MICTURITION-ASSOCIATED BRAIN ACTIVITY IN HEALTHY PATIENTS COMPARED TO STROKE SURVIVORS BEFORE AND AFTER TRANSCUTANEOUS SPINAL CORD STIMULATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP52-11 MICTURITION-ASSOCIATED BRAIN ACTIVITY IN HEALTHY PATIENTS COMPARED TO STROKE SURVIVORS BEFORE AND AFTER TRANSCUTANEOUS SPINAL CORD STIMULATION Sarah Ponce, Veronica Stefania Montero Arcila, Luis Alejandro Morales Ojeda, David Chapman, Rita Jen, Nhi Tuyet Ha, Parag Gad, V. Reggie Edgerton, Evgeniy Kreydin, Kay Jann, and Aidin Abedi Sarah PonceSarah Ponce More articles by this author , Veronica Stefania Montero ArcilaVeronica Stefania Montero Arcila More articles by this author , Luis Alejandro Morales OjedaLuis Alejandro Morales Ojeda More articles by this author , David ChapmanDavid Chapman More articles by this author , Rita JenRita Jen More articles by this author , Nhi Tuyet HaNhi Tuyet Ha More articles by this author , Parag GadParag Gad More articles by this author , V. Reggie EdgertonV. Reggie Edgerton More articles by this author , Evgeniy KreydinEvgeniy Kreydin More articles by this author , Kay JannKay Jann More articles by this author , and Aidin AbediAidin Abedi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Compared to healthy individuals, stroke survivors with neurogenic lower urinary tract dysfunction (NLUTD) exhibit decreased cortical activity in response to bladder filling and emptying. The use of transcutaneous spinal cord stimulation (TSCS) has been shown to reduce frequency, urgency and incontinence episodes in these individuals. The objective of this study was to determine whether TSCS also leads to normalization of micturition-related brain activity, as compared to healthy controls. METHODS: Twelve stroke patients with post-stroke NLUTD received 12 weeks of TSCS. Each subject also completed simultaneous urodynamics (UDS) and blood-oxygen-level-dependent (BOLD) fMRI before initiation of TSCS and within 72 hours of completing the final TSCS session. Healthy subjects without LUTS completed an identical fMRI-UDS protocol. BOLD signal during the period of maximum urgency (10 seconds preceding a detrusor contraction) was determined using statistical parametric mapping (SPM) and compared between healthy controls and stroke patients before and after TSCS (p<0.01, cluster size ⋝25 voxels). The SPM models were adjusted for age and sex. RESULTS: Compared to healthy controls, stroke survivors prior to TSCS exhibited diminished activation in the right cerebellum, left putamen, right insula, right anterior cingulate gyrus, right precuneus, bilateral medial frontal gyri, and right superior frontal gyrus compared to healthy controls. Following TSCS, there was no significant difference in BOLD signal in these regions between stroke survivors and healthy controls. However, healthy controls continued to exhibit increased activation in the right precentral (motor cortex) and left postcentral (sensory cortex) gyri, left posterior cingulate and left middle temporal gyrus even after TSCS. CONCLUSIONS: Micturition-related brain activity appears to partially revert to the healthy phenotype in stroke survivors following TSCS. Regions, where differences in BOLD signal between healthy controls and stroke subjects diminish following treatment, are known to be involved in LUT control. As expected, the neurosignature of stroke patients did not revert to the healthy phenotype entirely, as indicated by significant remaining differences in BOLD signal in several brain regions following TSCS. Source of Funding: Urology Care Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e706 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sarah Ponce More articles by this author Veronica Stefania Montero Arcila More articles by this author Luis Alejandro Morales Ojeda More articles by this author David Chapman More articles by this author Rita Jen More articles by this author Nhi Tuyet Ha More articles by this author Parag Gad More articles by this author V. Reggie Edgerton More articles by this author Evgeniy Kreydin More articles by this author Kay Jann More articles by this author Aidin Abedi More articles by this author Expand All Advertisement PDF downloadLoading ...